title: Utilizing an outcomes approach to improve pain management by nurses: a pilot study.
abstract: Effective pain management is a major challenge for nurses. The literature indicates that patients' pain continues to be inconsistently and ineffectively managed. The purpose of the pilot study was to measure the effectiveness of a structured intervention to improve pain management for patients. The "Serial V" model for clinical outcomes improvement was used to frame key clinical processes and was the basis for determining the outcome measures for the pilot project. The structured intervention used to integrate and standardize "best practice" for pain management by nurses consisted of a self-study module and the use of critical thinking exercises for patient pain management. Evaluation of outcomes demonstrated: (1) significant improvement over time in cognitive knowledge (p < 0.001) of staff nurses related to pain management; (2) overall patient satisfaction with pain management while hospitalized; (3) consistency in patients' ability to rate pain intensity; (4) consistency in patients' ability to identify their perceived "acceptable" level of pain; and (5) utilization of more consistent practice patterns of pain management by nursing staff. The pilot findings provide the foundation for ongoing development of additional strategies to improve patient pain management.
authors.affiliation: Critical Care and Emergency Services, Bryan Memorial Hospital, Lincoln, Nebraska, USA.
authors.forename: S
authors.initials: S
authors.lastname: Barnason
authors.forename: M
authors.initials: M
authors.lastname: Merboth
authors.forename: B
authors.initials: B
authors.lastname: Pozehl
authors.forename: M J
authors.initials: MJ
authors.lastname: Tietjen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002983:Clinical Competence; D004509:Education, Nursing, Continuing / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D009720:Nurse Clinicians; D009730:Nursing Assessment; D009741:Nursing Staff, Hospital / Q000193:education*; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D010146:Pain / Q000451:nursing*; D010147:Pain Measurement; D010865:Pilot Projects; D017410:Practice Guidelines as Topic